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Abstract This randomized controlled trial, conducted in Ain Shams university maternity hospital, aimed to compare between the efficacy of single conventional cerclage and cerclage with an occlusion suture in patients with cervical insufficiency. The diagnosis of cervical insufficiency was a retrospective diagnosis by history of preterm delivery and/or second trimester abortion. An informed consent was taken from all patients. Patients were randomly assigned to 2 groups, each group had 30 patients with cervical insufficiency: control group: underwent a McDonald cerclage study group: underwent a McDonald cerclage + an occlusion suture. Proper history taking, examination and preoperative investigations were performed for all patients. Preoperative medications and postoperative instructions were also assured. Data were statistically analysed. There was no significant difference between the two groups in maternal age, gestational age at operation, number of previous PTL <35 weeks and/or second trimester abortion and number of living children. The double cerclage group had a significantly higher mean gestational age at delivery and neonatal birth weight than the single cerclage group. The incidence of PPROM and rates of NICU admissions were significantly lower in the double cerclage group than in the single cerclage group. Results showed that the use of an occlusion suture with the conventional McDonald suture improved perinatal and maternal outcomes. We are also looking forward for the results of the multicenter randomized trial led by Neils Secher. |